Immediate salvage procedure for infected penile prosthesis.
OBJECTIVE
The most devastating complication after the insertion of a penile prosthesis is the development of infection. The standard approach involves removing the entire device, treating intensively with antibiotics and attempting to reinsert a prosthesis at a later date, often with a suboptimal result. Based on the encouraging results of others, during the last 24 months we have used in 2 separate private urological practices a salvage procedure for treatment of infected inflatable penile prostheses.


METHODS
The protocol used in 7 men with an infected inflatable penile prosthesis included removal of all device components, a 7-step vigorous intraoperative irrigation with 4 different solutions, including vancomycin, immediate reimplantation of a new inflatable penile prosthesis and postoperative outpatient antibiotics with oral ciprofloxacin or intravenous vancomycin or cefazolin.


RESULTS
Of the 7 men 6 have experienced excellent results with no infection, minimal morbidity and preservation of penile length. The only failure occurred in a poorly controlled diabetic who required multiple revisions and may have had latent infection for months before it became apparent.


CONCLUSIONS
We believe that an immediate salvage procedure for an infected inflatable penile prosthesis is an effective treatment for this difficult complication.
Kaufman
J M
JM
Kaufman
J L
JL
Borges
F D
FD
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D015917:Penile Prosthesis / Q000009:adverse effects*; D016459:Prosthesis-Related Infections / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D012086:Reoperation; D016879:Salvage Therapy
D000900:Anti-Bacterial Agents